Stem cell therapy applied for digestive anastomosis: Current state and future perspectives.

Area of Science:

• Gastroenterology
• Regenerative Medicine
• Surgical Innovation

Background:

• Anastomotic leakage is a severe complication following digestive tract resections, with high morbidity and mortality rates.
• Despite advancements, anastomotic leak rates have remained stagnant for decades.
• Stem cells (SCs) have emerged as a potential therapeutic strategy to enhance healing since 2008.

Purpose of the Study:

• To systematically review and summarize existing literature on the use of stem cells (SCs) for preventing leaks in digestive anastomoses.
• To assess the current evidence regarding SC application in improving the outcomes of hollow digestive viscera anastomoses and sutures.

Main Methods:

• Comprehensive literature searches were conducted in PubMed, Science Direct, Scopus, and Cochrane databases.
• Keywords included "anastomosis," "anastomotic leak," "stem cells," and "cell therapy" for articles published between 2000 and 2021.
• Studies involving SCs, digestive anastomoses, and healing monitoring were included; a meta-analysis was not feasible due to study heterogeneity.

Main Results:

• Eighteen preclinical studies and three reviews were identified; no clinical trials or registered trials were found.
• Experimental studies, primarily in rat and porcine models, indicated that SCs are safe and showed encouraging results in improving healing, even under adverse conditions.
• Mesenchymal stem cells delivered via local injection or cell sheets/biosutures were most common, but standardization of models and isolation processes is needed.

Conclusions:

• Stem cell therapy demonstrates potential for enhancing digestive anastomosis healing in preclinical settings.
• Significant heterogeneity and limitations in current research necessitate further investigation.
• The clinical application of stem cell therapy for digestive anastomoses is not yet established and appears distant.